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Author Topic: Fulkerson Osteotomy  (Read 139 times)

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Offline hedurhamel

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Fulkerson Osteotomy
« on: October 15, 2019, 03:51:13 AM »
Hello World of Kneeguru!  :)

After ending up on page 6 of Google trying to gain perspective on what to expect when recovering from a Fulkerson Osteotomy (Tibial Tubercle Osteotomy) surgery, I ended up discovering Knee Guru. I'm hoping someone who has gone through the procedure can shed some light on what to expect and let me know how the surgery went for them.

I also have not found anyone who have had a bilateral procedure? I'm currently planning on having one and would love to hear from someone who has needed the surgery on both knees and if they chose to do it simultaneously or space it out?

To give more context, I'm 23 years old and I've had patella tracking issues since I was about 12 years old for my right knee. The same issue in the left knee since I was 16. I endure patella subluxation 5-8 times a years. Depending on how badly my patella dislocates, I am unable to walk from a few hours to a few days. Most recently, I slipped and fell at work and dislocated both patellas simultaneously for the first time ever. This landed me a trip to the ER, a week off my feet and forced me to revisit the problem I've been avoiding for years.

After a MRI and X-Ray of both knees, the surgeon suggested a Fulkerson Osteotomy. Apparently this most recent dislocation lead to loose bodies in the right knee which needs to be removed. He warned me that I should deal with this while I'm young and can recover quickly. Not happy with the news, I traveled home to Florida and got a second opinion from an OS that's friends with my dad (who is an OS himself) and got a second opinion. He concluded that I need the surgery and that it'd be best to start with the right knee.

After some consideration, he's suggesting that I do them both simultaneously since I don't live in Florida anymore and have approvals to spend 3-6 month in Florida for recovery from work. I've been going crazy doing copious amount of research trying to figure out whether to do both knees or just the right one. Please comment your experiences, thoughts and considerations.

I'll be sure to post updated after I go under the knife on 11/11/19.

Offline kczech

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Re: Fulkerson Osteotomy
« Reply #1 on: November 05, 2019, 04:35:08 AM »
Hey there! Really sorry to hear about your situation, especially at such a young age (like me, I'm 25). While I don't have experience myself with TTT, it was something that my OS and I considered in conjunction with other procedures I had done. I've never had full dislocations, but the cartilage on my patellas is pretty shot from maltracking while I have been fairly active over the past several years. Two weeks ago, I had a proximal tibia osteotomy to address my torsional and varus malalignments which seemed to be at the root of my issues (mine is the only other recently active diary if you'd like to read more). I know it's not the same thing as your surgery, but I couldn't imagine having to go through with both legs at the same time. I originally thought I wanted to do both at the same time, but I'm glad I didn't. Right now, I'm planning to have the other leg done in another 4 months or so. Yours may very well be a lot easier to deal with though. It would be worth asking if you will be weight bearing right away, how long you would be on crutches, what kind of movement restrictions, etc.

Do you know what your TT-TG measurement is? Just curious. Mine on the left is ~17mm (normal being 10-15 from my understanding) and we decided not to move the tubercle in my case because it is fairly close to the norm.
L. Tibia derotational and medial open wedge osteotomy - Oct. 23, '19

"It is not the mountain we conquer, but ourselves." -Edmund Hillary

Offline hedurhamel

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Re: Fulkerson Osteotomy
« Reply #2 on: November 07, 2019, 03:31:15 PM »
Hey Kczech,

Thank you for the kind response and concern. I hope your recovery is going smoothly and you're on track to conquer more 14ers (read your diary)!

My surgery is set for 11/11/19, but after reviewing options with my OS we decided to move forward with just starting with one knee (the right one). I also got insight to all the lovely procedures he's performing on my knee:
  • Right knee arthroscopy to remove loose body
  • Lateral Release
  • Open Fulkerson Osteotomy
  • Open VMO Advancement

My TT-TG is ~20mm on both knees, might be why he's opting to move the tubercle haha. Depending on what recovery is like I'm either going to get the left knee done on 1/2020 or 11/2020.

Please keep updating your recovery diary! You got this, it'll hopefully all be worth it in the end. :)

Offline kczech

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Re: Fulkerson Osteotomy
« Reply #3 on: November 10, 2019, 12:32:28 AM »
Thank you for the well wishes. It has been a goal of mine for many years to climb all the 14ers in the lower 48, so I sure hope you're right! It sucks that things like this hold us back from experiencing life to the fullest, but I use that as motivation for getting through my recovery, and I hope you're able to do the same!

Seems like a fairly potent combination of procedures. Patellar instability is such a multifaceted issue and there's never any one right answer for solving it, but I hope that is what's right for you and I wish you the best!

I look forward to following your recovery as well :)
L. Tibia derotational and medial open wedge osteotomy - Oct. 23, '19

"It is not the mountain we conquer, but ourselves." -Edmund Hillary